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February 5, 20260 citations

Ecchordosis physaliphora presenting with cerebrospinal fluid leak and meningitis: illustrative case.

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KBKishore BalasubramanianJZJeffrey ZuccatoEREdward El Rassi

Key Points

  • To report a unique case of long-standing rhinorrhea and meningitis caused by a clival ecchordosis physaliphora (EP).
  • Case report detailing the clinical presentation and management of the patient.
  • Assessment of cerebrospinal fluid (CSF) rhinorrhea along with imaging studies.
  • Evaluation of meningitis development in relation to the clival lesion.
  • This is the first documented instance of meningitis resulting from an EP-related CSF leak.
  • Early identification of the CSF leak is crucial to prevent meningitis progression.

Abstract

This is the first case of long-standing rhinorrhea and presentation of meningitis from a clival lesion, and it is one of the few cases of EP-related meningitis. Early recognition and workup of CSF rhinorrhea is critical to avoid progression to meningitis, and EPs are a rare cause of this presentation. https://thejns.org/doi/10.3171/CASE25540.

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Cite This Study

Balasubramanian et al. (2026) studied this question.

synapsesocial.com/papers/698435c9f1d9ada3c1fb4fa8https://doi.org/10.3171/case25540
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